With Average Step Score 230 this year is Step 1 getting ridiculous?

[twospadz]

Opinions. Just feel like Step 1 scores are getting really high. Anyone else feel this way. Also, what should be done.

---

Members don't see this ad.

 

[Wordead]

Start an online social media campaign with a catchy hashtag protesting it

Start a change.org petition

Or just ****ing study

 

[Psai]

Just wait til you see the average for step 2

 

[sliceofbread136]

Hopefully someone can clear up my confusion alittle... if the test is percentile based then why does it matter what number they make the average? It seems like it would be arbitrary to me

 

[ALUCSD18]

Hopefully someone can clear up my confusion alittle... if the test is percentile based then why does it matter what number they make the average? It seems like it would be arbitrary to me

It's all about context. Scores are meaningless unless you look at the testing as a whole. What I mean by that is looking at the mean and seeing where your score falls relative to others. Scores increase every year, usually by one or two points. So 5-10 years ago, a 230 would be a great score. Now it's "average."

 

[collegestud2013]

Hopefully someone can clear up my confusion alittle... if the test is percentile based then why does it matter what number they make the average? It seems like it would be arbitrary to me

While percentiles are used in the scoring process, Step 1 scores are not scaled to a fixed mean and standard deviation which allows the scores to go up from year to year (presumably because students are answering a greater percentage of the questions correctly after adjusting for the difficulty of the questions). The scores have gone up from year to year probably because the test hasn't chanced significantly for a while, so more and more people are getting their hands on a the high-yield information and the better strategies to beat the test (which has become more readily available via the internet, test prep companies, other students, etc...). In short, the amount of resources available for the exam just keeps going up each year.

The increase is scores can be problematic for people who take time off during med school after they've taken Step 1 (esp. if they're MD/PhD and will be taking 4 years off in between 2nd and 3rd year of med school), especially if already have a significantly below-average score for their specialty at the time they take the test (by this I'd say more than 10 points below the avg). Though I suppose they can always compensate with Step 2, and people who take off time for research usually have something decent to show to residency PDs to compensate.

 

[Bluvip]

To serve their students better, school curriculums should align as closely as possible to the step 1 content. For whatever reason it is a standard by which PD will judge...To give students their best shot at a residency, I believe this is a good start.

Lots of the school curriculum is bogged down with unnecessary material that will likely be forgotten by the student. If the USMLE examiners determine there is a standard material that should be known then why not concentrate the curriculum to that?

Look at Baylor with curriculums that was 1.5yrs last time I checked. They are pretty high (in the 240 range for Baylor). Also, look at some Caribbean schools...they train for step 1.

Step 1 is NOT as daunting as it seems... it is just lost in the background of the burden of the particular medical school curriculum.

Just my thoughts.

 

[Dave89]

I wouldn't be surprised if they completely revised the exam's grading in several years, just as MCAT creep was reset with that test's overhaul.

Overall, it's probable that the rising mean is not a positive sign, but an indication that medical school is becoming more about studying for tests than it is about learning medicine for the sake of learning medicine.

 

[Bluvip]

You don't feel like you're learning about medicine when studying for Step 1?

 

[Dave89]

You don't feel like you're learning about medicine when studying for Step 1?

I learned plenty of medicine, but things stick differently when you learn for the sake of knowledge rather than for the sake of acing an exam.

 

[Psai]

To serve their students better, school curriculums should align as closely as possible to the step 1 content. For whatever reason it is a standard by which PD will judge...To give students their best shot at a residency, I believe this is a good start.

Lots of the school curriculum is bogged down with unnecessary material that will likely be forgotten by the student. If the USMLE examiners determine there is a standard material that should be known then why not concentrate the curriculum to that?

Look at Baylor with curriculums that was 1.5yrs last time I checked. They are pretty high (in the 240 range for Baylor). Also, look at some Caribbean schools...they train for step 1.

Step 1 is NOT as daunting as it seems... it is just lost in the background of the burden of the particular medical school curriculum.

Just my thoughts.

no, the school's curriculum should be about teaching doctors, not teaching step 1
you will forget pretty much everything and have to look it up again and again
there's more to being a doctor than taking multiple choice tests

 

[Merely]

I learned plenty of medicine, but things stick differently when you learn for the sake of knowledge rather than for the sake of acing an exam.

Who the hell wants to learn for the sake of knowledge? Idk about you but I'd rather party than learn glycolysis.

 

[tiedyeddog]

Who the hell wants to learn for the sake of knowledge? Idk about you but I'd rather party than learn glycolysis.

Part of becoming a doctor is wanting to be a life-long learner, you should have some drive to update and advance your knowledge. This is a fact you must accept or you will hurt people.

 

[Bluvip]

no, the school's curriculum should be about teaching doctors, not teaching step 1
you will forget pretty much everything and have to look it up again and again
there's more to being a doctor than taking multiple choice tests

The knowledge you gain and require to ace step 1 is standardized. It is the first step to "teaching doctors". Pardon, but what do you mean by that, anyways? Do you refer to the touchy feely side of medicine? The way I see it - Step 1 it is a foundation to ease into the language of medicine you will encounter in MS3. Unfortunately you need to measure the knowledge base because people need to be held accountable not just say "I learned and appreciate everything." Hence the multiple choice test.

Perhaps it is no accident that it is an extremely important part of residency application. If not just for that reason - putting all idealism aside - school's should teach step 1 first and foremost during the non-clinical year(s). The clinical curriculum should be expanded to 2.5 years at least.

 

[Dave89]

The clinical curriculum should be expanded to 2.5 years at least.

I agree with this.

 

[DrBowtie]

I agree with this.

Disagree. You learn more actual medicine in your first few months of internship than in your entire clinical rotations combined.

Medical student duties have become so diluted, they aren't helpful except cursory exposure to different fields

 

[notbobtrustme]

2.5 clinical curriculum? oh hell no.

just recognize what medical school is really for, a very expensive, drawn out application to residency programs. the days of being competent upon graduation are long gone and nothing will fix that. The difference between an average med student and a superstar is like 10 days in your intern year. Meaning that, the vast majority of training and expertise comes from on the job training, not the playskool imitation we see in medical school.

 

[Dave89]

Disagree. You learn more actual medicine in your first few months of internship than in your entire clinical rotations combined.

Medical student duties have become so diluted, they aren't helpful except cursory exposure to different fields

The question is whether this could be changed with a longer clinical curriculum. It seems intuitive that more time spent on the floors would translate to more competence on graduation (and, indeed, in 4th year), but I suppose that I won't have the complete picture for a couple of years.

I'll have to take your more-experienced word for it.

 

[Wordead]

The question is whether this could be changed with a longer clinical curriculum. It seems intuitive that more time spent on the floors would translate to more competence on graduation (and, indeed, in 4th year), but I suppose that I won't have the complete picture for a couple of years.

I'll have to take your more-experienced word for it.

Yeah, no, it absolutely does not translate.

 

[operaman]

There are a number of medical schools that are experimenting with longer clinical experiences. I think success will hinge on how they implement it. 2.5-3 years of clinical rotations if most of your time is spent quasi-shadowing is probably not terribly helpful; but that same time with those awesome attendings and residents who love to teach and really involve students in patient care? Priceless. In a school with the right culture and a serious buy-in from faculty, it could be very powerful. There's a danger in considering medical education simply in terms of hours and years without giving serious thought to the quality of those experiences.

 

[Señor S]

Disagree. You learn more actual medicine in your first few months of internship than in your entire clinical rotations combined.

Medical student duties have become so diluted, they aren't helpful except cursory exposure to different fields

This seems right to me. What would an extra 6 months really accomplish? My experience thus far is that to the extent medical students have limited responsibilities it's due to cultural/legal factors, not a lack of time. And I'm still confident that by the end of residency we'll all know what we need to know, even if we're not quite as "independent" as the interns of yesteryear.

 

[rocklobstr]

Opinions. Just feel like Step 1 scores are getting really high. Anyone else feel this way. Also, what should be done.

Read about the Flynn effect on wikipedia.

 

[Frazier]

Opinions. Just feel like Step 1 scores are getting really high. Anyone else feel this way. Also, what should be done.

So was the mean at 230 on your score report?

Back in April mine said 228 mean, iirc.

 

[Psai]

The knowledge you gain and require to ace step 1 is standardized. It is the first step to "teaching doctors". Pardon, but what do you mean by that, anyways? Do you refer to the touchy feely side of medicine? The way I see it - Step 1 it is a foundation to ease into the language of medicine you will encounter in MS3. Unfortunately you need to measure the knowledge base because people need to be held accountable not just say "I learned and appreciate everything." Hence the multiple choice test.

Perhaps it is no accident that it is an extremely important part of residency application. If not just for that reason - putting all idealism aside - school's should teach step 1 first and foremost during the non-clinical year(s). The clinical curriculum should be expanded to 2.5 years at least.

what comes up on step 1 and what you see in ms3 are very different
it's an extremely important part of residency applications only because it is standardized across the entire nation and everyone has to take it. it's not because it has some intrinsic value beyond establishing a measure of minimum competency

So was the mean at 230 on your score report?

Back in April mine said 228 mean, iirc.

i think mine said 230 in july

 

[tiedyeddog]

Disagree. You learn more actual medicine in your first few months of internship than in your entire clinical rotations combined.

Medical student duties have become so diluted, they aren't helpful except cursory exposure to different fields

This couldn't be more true for me, I have learned more about the actual clinical practice of medicine in the past three weeks of internship than I learned in the entire fourth year of medical school. Medical school education involves so little responsibility for the student, you really aren't learning until you're the one responsible for all parts of a patient's care.

 

[pd1112]

To serve their students better, school curriculums should align as closely as possible to the step 1 content. For whatever reason it is a standard by which PD will judge...To give students their best shot at a residency, I believe this is a good start.

Lots of the school curriculum is bogged down with unnecessary material that will likely be forgotten by the student. If the USMLE examiners determine there is a standard material that should be known then why not concentrate the curriculum to that?

Look at Baylor with curriculums that was 1.5yrs last time I checked. They are pretty high (in the 240 range for Baylor). Also, look at some Caribbean schools...they train for step 1.

If this was a good way to train future physicians, Caribbean grads wouldn't have such a hard time matching.

 

[notbobtrustme]

If this was a good way to train future physicians, Caribbean grads wouldn't have such a hard time matching.

that has more to do with their international status than teaching to the boards.

 

[Bluvip]

If this was a good way to train future physicians, Caribbean grads wouldn't have such a hard time matching.

Caribbean grads are Caribbean grads for a reason. My point is that there should be a more concentrated step 1 curriculum for success for all students. Then whatever time is left over after cutting up what is just extra weight could be spent on clinical rotations or some type of research.

 

[pd1112]

that has more to do with their international status than teaching to the boards.

And why does international status make it harder to match?

 

[anaesthetic]

.

 

[Flamen04]

And why does international status make it harder to match?

Well some people have international status because they couldn't get accepted into an US medical school in the first place so it makes them less desirable than US grads. Also, the match should favor US trained medical school graduates since you know.. the government invested in them by providing them with loans, which they would like to be repaid..

 

[pd1112]

Caribbean grads are Caribbean grads for a reason. My point is that there should be a more concentrated step 1 curriculum for success for all students. Then whatever time is left over after cutting up what is just extra weight could be spent on clinical rotations or some type of research.

I see your point, I just don't agree with it. I think the "extra weight" is what gives medical school it's place in academia and the training of professionals, as opposed to a trade/technical school. Research isn't for everyone and I don't think it should be, and others have spoken to the relative futility of clinical rotations. Also, if you've ever seen the list of topics produced by the USMLE for Step 1, it's extremely vague. In my N=1, it always seemed like professors were going into way too much detail, because a lot of what was mentioned/taught was not explained or mentioned in boards review books. But glancing at the topic list, you could argue that it was all there.

Well some people have international status because they couldn't get accepted into an US medical school in the first place so it makes them less desirable than US grads. Also, the match should favor US trained medical school graduates since you know.. the government invested in them by providing them with loans, which they would like to be repaid..

So you're saying international training is equivalent to U.S. training, but international is just less desirable because it's the second option and because they want spots filled with U.S. grads for loan repayment?

 

[Psai]

Caribbean grads are Caribbean grads for a reason. My point is that there should be a more concentrated step 1 curriculum for success for all students. Then whatever time is left over after cutting up what is just extra weight could be spent on clinical rotations or some type of research.

bro you barely took step 1
did you even get your score back

 

[Bluvip]

bro you barely took step 1
did you even get your score back

Yes I got my score back. What does having recently taken step 1 have to do with anything? We are talking about step 1 what else do I need to be qualified to present my opinion lol

 

[pd1112]

Success for all students? There's already a 96-97% 1st time pass rate. What else do you want?

 

[Bluvip]

Success for all students? There's already a 96-97% 1st time pass rate. What else do you want?

This thread isn't about passing. It's about the increasing averages. Success is relative and with increasing averages success is no longer about just passing. At leasts that's what I got from OP's request for opinions.

 

[Psai]

Yes I got my score back. What does having recently taken step 1 have to do with anything? We are talking about step 1 what else do I need to be qualified to present my opinion lol

because your opinion is that medical school should teach to step 1 but you've barely had a taste of what medicine is
there's a ton of stuff on step 1 that you probably won't ever see in real life and things you will see a ton in real life that isn't emphasized on step 1

 

[Bluvip]

because your opinion is that medical school should teach to step 1 but you've barely had a taste of what medicine is
there's a ton of stuff on step 1 that you probably won't ever see in real life and things you will see a ton in real life that isn't emphasized on step 1

I can appreciate that. I just think that if residency programs are looking it at it with such importance then fight fire with fire. It's rough seeing people scratch off specialties off their list because of a 3 digit number.

Speaking of real life: When you begin your ENT residency, how real life is your OB/Gyn rotation in medical school? Probably not real life.

 

[pd1112]

This thread isn't about passing. It's about the increasing averages. Success is relative and with increasing averages success is no longer about just passing. At leasts that's what I got from OP's request for opinions.

I can appreciate that. I just think that if residency programs are looking it at it with such importance then fight fire with fire. It's rough seeing people scratch off specialties off their list because of a 3 digit number.

So...? Say every school concentrates solely on Step 1, the average goes up to 245 & the SD is 8. The pool of med students gets increasingly homogenous & there's one less measurement to distinguish yourself from other students. How does this help anyone?

 

[Psai]

I can appreciate that. I just think that if residency programs are looking it at it with such importance then fight fire with fire. It's rough seeing people scratch off specialties off their list because of a 3 digit number.

Speaking of real life: When you begin your ENT residency, how real life is your OB/Gyn rotation in medical school? Probably not real life.

because pregnant women don't get ent disorders
and their babies don't either

 

[Bluvip]

So...? Say every school concentrates solely on Step 1, the average goes up to 245 & the SD is 8. The pool of med students gets increasingly homogenous & there's one less measurement to distinguish yourself from other students. How does this help anyone?

My guess is that other factors will probably gain more importance when PD consider applicants. Then it's another story

 

[Bluvip]

because pregnant women don't get ent disorders
and their babies don't either

touche

 

[DrBowtie]

because pregnant women don't get ent disorders
and their babies don't either

Real life is you're not managing any of the OB stuff as an ENT. OB Consult!

 

[DancingDoggie]

del.

 

[operaman]

Real life is you're not managing any of the OB stuff as an ENT. OB Consult!

"yeah, we've got this patient on our service with some sort of growth in her uterus that we'd like you to come take a look at and give us some recs..."

 

[cs24]

This thread isn't about passing. It's about the increasing averages. Success is relative and with increasing averages success is no longer about just passing. At leasts that's what I got from OP's request for opinions.

A bell curve is a bell curve no matter where the average is. (and yes I realize that is probably isn't a perfect bell curve).

What people posting these threads always seem to want is for the average to decrease while their score remains the same, because they are clearly a special snowflake who would have gotten the same score they got today 5-10 years ago when the average was much lower and review resources were worse.

Also, IMO, step 1 being no longer about just passing has more to do with fewer residency spots per applicant than the relative step 1 mean. The step 1 mean could be 190 but if the score was still given as much weight as it currently is it would still be just as big of a factor for residency apps.

 

[notbobtrustme]

Ugh, incoming M1 here. As I read this it makes perfect sense. But gee that's a bummer considering that's how I felt about undergrad re: medical school. At least I found undergrad to be valuable for my intellectual development and I feel as though I got a lot out of it.

Given that this is how you see medical school, do you feel like you still got/are getting a lot out of the experience (aside from your residency spot).

med school is useful because you learn the language and the beginnings of how to think like a doctor. and you do learn how to manage things, just not efficiently or effectively. There's only so much you can see in a 4-8 week rotation, especially with the kid gloves on. And finally, there's basically no incentive to teach and involve med students. You have to teach and make the interns part of the team because you are working with them 12-14 hours a day for the next 2-3 years. Med students will only be around for a couple weeks. So the vast majority of learning comes through osmosis and then when you have to handle the real deal, you stumble like a 2 legged horse (and not the good kind).

 

[Gadofosveset]

If it's true that the "bell" curve mean is increasing and the SD is decreasing, then it might seem that this is going to put higher pressure on you. Like having a bad day and being off a few points is going to disastrously wreck your application. But as @cs24 pointed out, this is still a bell curve... so, assuming you study like the average med student, you're still 95% likely to be within 2 SD, whatever the mean.

This phenomenon is really a problem for two groups:
1) med students who were going to rely only on their Step 1 to distinguish them from other med students
2) program directors, who will have increasing trouble differentiating based on Step 1 scores.

 

[Goro]

OP, MCAT medians for MD (and DO) school matriculants have been going up as well over the past decade. One could surmise either the tests are getting easier, but I like to think that the students are getting smarter!

Step I is for all those building blocks. You don't use them actively in the clinic, but when you see an 8o year old woman with abdominal pain, vomiting and black stools, you immediately don't think about A, B and D, but start thinking about C, E and F. Now throw in a positive urease test, and you go right to E or F. You don't think about virulence factors of H pylori or the microanatomy of the stomach wall, but they're there.


IMgs, particularly carib grads, have a large list of differentials that make them high risks for PDs. Things like inability to delay gratification, gullibility, parental pressure, poor research skills...

And why does international status make it harder to match?

I can now hear every one of my clinical colleagues saying "we DID teach you that...you just forgot it!"

Just started intern year. I can't count the number of times I've thought, said, or heard, "They did not teach us this in med school."

 

[jw3600]

This phenomenon is really a problem for two groups:
1) med students who were going to rely only on their Step 1 to distinguish them from other med students
2) program directors, who will have increasing trouble differentiating based on Step 1 scores.

*1) DO students. ****.